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Doximity: Physician Compensation Growth Stalls in 2020

Analysis  |  By Christopher Cheney  
   October 30, 2020

According to San Francisco-based Doximity, average physician pay has increased 1.5%.

Physician compensation growth has stagnated in 2020, according to a new report from Doximity.

The healthcare sector is under several financial strains during the coronavirus pandemic. Hospitals are losing billions of dollars, and a new American Medical Association survey found physician practice revenue was down an average of 32% this summer.

The new Doximity report, which is based on surveys of 44,000 full-time physicians conducted in 2019 and 2020, found average pay for physicians increased 1.5%. Previous Doximity physician compensation reports found physician compensation growth ranging from 3% to 5%.

The coronavirus pandemic is a likely driver of the tepid growth rate for physician compensations, says Peter Alperin, MD, vice president at Doximity and a staff physician at California Pacific Medical Center in San Francisco.

"We did find that the overall physician compensation was pretty flat as compared to the typical 3% to 5% increases we have seen in previous years. We are not 100% sure of the cause, but COVID-19 is most certainly playing a role."

Even if hospital and physician practice finances stabilize before the end of the year, any increase in 2020 physician compensation is likely to be modest, he says. "We know that hospitals and private practices have seen significant declines in revenue because of patient visits being cancelled and there being a switch over to telehealth. That said, a lot of that is coming back, so where things will end up at the end of the year is a bit of a guess. But the increase in compensation is unlikely to reach the 4% level that we have seen in previous years."

By the numbers

The new Doximity report has several key data points.

Metro areas with the highest compensation for physicians in 2020:

1. Milwaukee, WI — $430,274

2. Atlanta, GA — $428,244

3. Jacksonville, FL — $427,090

4. Buffalo, NY — $407,070

5. Orlando, FL — $406,587

Metro areas with the lowest compensation for physicians 2020:

1. San Antonio, TX — $329,475

2. Virginia Beach, VA — $331,952

3. Boston, MA — $347,894

4. Baltimore, MD — $348,389

5. Washington D.C. — $351,572

The five specialties with the highest average annual compensation rate:

1. Neurosurgery $746,544

2. Thoracic Surgery $668,350

3. Orthopedic Surgery $605,330

4. Plastic Surgery $539,208

5. Oral & Maxillofacial $538,590

The five specialties with the lowest average annual compensation rate:

1. Preventive Medicine $234,587

2. Pediatrics $243,253

3. Medical Genetics $252,930

4. Endocrinology $259,748

5. Family Medicine $261,536

Top five specialties with the largest increase in average annual compensation:

1. Vascular Surgery 4.9%

2. Physical Medicine/Rehab 4.7%

3. Geriatrics 4.6%

4. Genetics 4.4%

5. Emergency Medicine 4.3%

Gender wage gap: The new Doximity report found that the wage gap between male and female physicians was 28%, with male doctors earning over $116,000 more annually than their female counterparts. In last year's Doximity physician compensation report, the gender pay gap was to 25%.

Interpreting the data

The impact of the coronavirus pandemic is reflected in the new physician compensation data, Alperin says.

The increase in the gender pay gap is likely related to the pandemic, he says. "It could be that female physicians are decreasing their work hours more than male physicians to help take care of family members. It is certainly something to watch. If we see this as a trend over the next couple of years, it would be alarming."

The pandemic has affected compensation growth for specialties in high demand during the crisis, Alperin says.

"We have seen relatively high compensation increases in specific specialties—including geriatrics and emergency medicine. The increases in compensation for geriatrics and emergency medicine are almost certainly because of demand driven by COVID-19. With elderly patients, geriatrics is a field that is always in demand; but with COVID-19 there is a lot more going on with elderly patients. For emergency medicine, emergency rooms have been hard hit by COVID-19."

Despite the disruptive effects of the pandemic on physician compensation, robust growth in doctor pay should be expected in the long run, he says.

"Over the long term, it is unlikely that we are going to see any fundamental change in physician compensation because the fundamentals of demand for physicians have not changed. Some patients are foregoing their required screenings and other sorts of medical care, but patients who need services such as knee replacements are still going to need those services. So, the underlying fundamentals have not changed, nor have the fundamentals related to the number of physicians. For example, it takes a lot of time to start a new medical school."

Rather than having an enduring impact on physician compensation, the pandemic appears to be a catalyst for change in where doctors practice, Alperin says.

"There is unlikely to be a long-term change in physician compensation. However, there could be a long-term change in how physicians are employed. The pandemic could accelerate the change from private practice toward more physicians being employed by large physician groups and hospitals, because the impact of the shutdown in the early phase of the pandemic was intense for many private practices. There were many private practices that were not well capitalized to withstand the storm."

Related: Physician Compensation Rose Again But COVID-19 Expected to 'Dramatically Alter' Landscape

Christopher Cheney is the CMO editor at HealthLeaders.


KEY TAKEAWAYS

The coronavirus-related financial strains on hospitals and physician practices are a likely driver of weak physician compensation growth this year.

A new Doximity physician compensation report found the physician gender pay gap increased 3 percentage points over the past year, with male doctors earning over $116,000 more annually than their female counterparts.

The report found specialties that are in high demand during the pandemic such as geriatrics and emergency medicine have experienced relatively high physician compensation growth.

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